title: Risk of nonpsychotic mental disorders development in antiviral-treated mentally healthy chronic hepatitis C patients: A population-based study.
abstract: OBJECTIVE
  Interferon (IFN) is able to induce significant psychiatric side effects in chronic hepatitis C (CHC) patients, whereas the risk of nonpsychotic mental disorder (NPMD) development in antiviral-treated mentally healthy CHC patients remains obscure. We used a population-based study to assess the risk of NPMD development in patients who had undergone antiviral treatment compared with untreated chronic hepatitis C virus (HCV)-infected and nonalcoholic fatty liver disease (NAFLD) patients.
  
  
  METHODS
  Data were retrieved from Taiwan's National Health Insurance Research Database cohort consisting of 1 million individuals for a longitudinal analysis. A total of 313 mentally healthy CHC patients who received IFN-based antiviral therapy were recruited and compared with those without antiviral therapy and NAFLD patients. The Chi-square test was used to obtain the hazard ratio and 95% confidence interval.
  
  
  RESULTS
  Among the 313 CHC patients receiving pegylated interferon/ribavirin therapy, 62 patients (19.8%) were associated with NPMD. In the comparison cohort, composed of 313 age- and sex-matched CHC patients not receiving antiviral therapy, 70 patients (22.4%) were associated with NPMD. The Chi-square analysis revealed that antiviral therapy was not significantly associated with NPMD. The diagnosis of HCV-infected hepatitis was independently associated with NPMD when compared with NAFLD. The hazard ratio was 1.67 (95% confidence interval, 1.11-2.52; p = 0.018). Furthermore, generalized anxiety disorder was specifically higher in HCV-infected patients than those with NAFLD.
  
  
  CONCLUSIONS
  Patients with HCV infection are at high risk of developing NPMD with or without IFN-based therapy.
authors.affiliation: School of Nursing, China Medical University, Taichung, Taiwan; Department of Nursing, Central Taiwan University of Science and Technology, Taichung, Taiwan.
authors.forename: Shu-Chuan
authors.initials: SC
authors.lastname: Chang
authors.affiliation: Department of Healthcare Administration, Central Taiwan University of Science and Technology, Taichung, Taiwan.
authors.forename: Chin-Tun
authors.initials: CT
authors.lastname: Hung
authors.affiliation: Department of Healthcare Administration, Central Taiwan University of Science and Technology, Taichung, Taiwan.
authors.forename: Shu-Fen
authors.initials: SF
authors.lastname: Li
authors.affiliation: Institute of Pharmaceutical Sciences and Technology, Central Taiwan University of Science and Technology, Taichung, Taiwan.
authors.forename: Horng-Mo
authors.initials: HM
authors.lastname: Lee
authors.affiliation: Department of Nursing, Central Taiwan University of Science and Technology, Taichung, Taiwan.
authors.forename: Yueh-Chin
authors.initials: YC
authors.lastname: Chung
authors.affiliation: Department of Nursing, Central Taiwan University of Science and Technology, Taichung, Taiwan.
authors.forename: Lee-Wen
authors.initials: LW
authors.lastname: Pai
authors.affiliation: Department of Nursing, Central Taiwan University of Science and Technology, Taichung, Taiwan; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan. Electronic address: yansh@vghtc.gov.tw.
authors.forename: Sheng-Shun
authors.initials: SS
authors.lastname: Yang
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D016208:Databases, Factual; D004359:Drug Therapy, Combination; D005260:Female; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000453:epidemiology*; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D009313:National Health Programs; D065626:Non-alcoholic Fatty Liver Disease / Q000453:epidemiology*; D011569:Psychiatric Status Rating Scales; D012254:Ribavirin / Q000627:therapeutic use; D012307:Risk Factors; D013624:Taiwan
chemical_list: D000998:Antiviral Agents; D016898:Interferon-alpha; D012254:Ribavirin
keywords: antiviral therapy; chronic hepatitis C; nonalcoholic fatty liver disease; nonpsychotic mental disorders; population-based study